Article

Pattern of gastrointestinal and psychosomatic symptoms across the menstrual cycle in women with inflammatory bowel disease

Türkiye Yüksek Ihtisas Hospital, Department of Gastroenterology, Ankara, Turkey.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology (Impact Factor: 0.47). 01/2004; 14(4):250-6.
Source: PubMed

ABSTRACT The purpose of this study was to determine the frequency of defecation, gastrointestinal (GI) and non-GI symptoms among women with ulcerative colitis (UC) (n=38) and Crohn's disease (CD) (n=21), and to compare the results with those from healthy women (n=38) across the menstrual cycle.
Women were followed for three menstrual cycles with a symptom diary consisting of frequency of defecation, and GI and non-GI symptoms. One point was allowed for each symptom in the same phases of three cycles, and total scores for GI and non-GI symptoms were obtained.
Frequency of defecation was found to be higher during menstruation in controls and in remitting UC and CD. GI symptom scores were higher in all three phases in patients with CD. These decreased in the postmenstrual phase in controls, and in patients with UC and remitting CD. In all three cycles, non-GI symptom scores were higher in patients with CD. These symptoms decreased during the postmenstrual period in all three groups. The activation of UC and CD did not affect the non-GI symptom score in the same menstrual cycle. Patients on mesalamine had less GI and non-GI complaints than those on sulfasalazine in all phases. There was no correlation between GI and non-GI symptom scores during all menstrual phases.
Cyclic pattern present in healthy women persisted in patients with UC and CD. Disease activity and the drug used may modify the severity of the symptoms.

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    • "The second study prospectively evaluated 97 subjects, 59 with IBD and 38 healthy controls. Patients in both IBD and control groups reported worse GI symptoms during menses than pre- or post-menses [14]. "
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    • "Studies that have assessed the prevalence of various GI symptoms perimenstrually have generally concluded that GI symptoms were more common for those with GI disorders than for healthy women [1,3,14,15]. It was evident in our study that GI symptoms were quite prevalent for healthy women as well, as over 70% experienced GI symptoms in conjunction with their menstrual cycle, even when potential gynecological symptoms such as bloating were excluded. "
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    • "However, their study was a retrospective study based on telephone interviews, so the subjects may have over reported their symptoms. Parlak et al.16 conducted a similar study assessing the pattern of GI and psychosomatic symptoms during the menstrual cycle in women with IBD. They demonstrated that there is a cyclic pattern in defecation during the menstrual phase.16 "
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